We’re delighted to announce that a new trial screening programme for type 1 diabetes, the ELSA study, which we’re funding in partnership with JDRF, is open for recruitment today. The first research of its kind in the UK will identify children at high risk of type 1 diabetes, laying the groundwork for the development of a potential UK-wide screening programme. This could transform the way the condition is identified and managed in its earliest stages.
The ELSA study (EarLy Surveillance for Autoimmune diabetes) will recruit 20,000 children aged between three and 13 to assess their risk of developing type 1 diabetes.
Spotting early warning signs through the ELSA study
Type 1 diabetes is caused by an immune system attack on insulin-producing cells in the pancreas. It’s possible to spot the very earliest signs that the immune system is planning an attack and find people who have a high risk of developing type 1 diabetes in the future.
The ELSA study will screen children for these signs, called autoantibodies, using blood tests. Autoantibodies are tools used by the immune system to mark insulin-producing cells for destruction. They can appear in the blood years, or sometimes decades, before people begin to experience any symptoms and receive a type 1 diagnosis.
Your risk of type 1 diabetes increases with the number of different autoantibodies found in the blood. People with two or more autoantibodies have an 85% chance of developing type 1 diabetes within 15 years, and it’s almost certain that they will develop the condition in their lifetime.
The ELSA study team will offer children found to be at risk and their families support and education, including information on symptoms, insulin injections and carb counting. This will help prepare them for a future diagnosis of type 1 diabetes. Families can also be followed up and monitored in the long term, and potentially start insulin treatment sooner.
The earliest, safest diagnosis
It’s essential type 1 diabetes is diagnosed quickly to avoid life-threatening complications. However, over a quarter of children aren’t diagnosed with type 1 diabetes until they are in diabetic ketoacidosis (DKA), a potentially fatal condition that requires urgent hospital treatment. Research in Europe and the USA has found that the extra support and monitoring type 1 diabetes screening programmes can offer dramatically reduces the risk of being diagnosed in DKA.
While the only treatment we currently have for type 1 diabetes is insulin, there are new immunotherapy treatments being tested that could prevent or delay the condition. Children found to be at high risk as part of ELSA could be invited to take part in research testing these treatments. One immunotherapy drug, called teplizumab, has been found to delay a diagnosis of type 1 diabetes by up to three years. It's currently being reviewed for use in the UK.
The ELSA study team will interview families and healthcare professionals who take part in the study to understand their views on screening and the most effective way to deliver a future screening programme. These insights will be important in making the case for widespread routine screening for type 1 diabetes in the UK.
Jayne and Mike Fairclough from St Helen’s have two daughters, Libby, aged 6, and Lottie, aged 2. Libby was diagnosed with type 1 diabetes in 2019. Jayne said: